SAMUEL STEPHENS KINGSLEY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049453

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

STEPHENS

Last Name

KINGSLEY

Suffix

Business Name

SAMUEL STEPHENS KINGSLEY MD

Original Issue Date

06/24/2005

Effective Date

06/24/2005

Expiration Date

06/23/2008

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

06/26/2008